[Neonatal cardiac failure secondary to hypocalcemia caused by maternal vitamin D deficiency].

Archives francaises de pediatrie Pub Date : 1993-11-01
I Memmi, R Brauner, D Sidi, S Sauvion, J C Souberbielle, M Garabedian
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Abstract

Background: Heart failure is a rare manifestation of neonatal hypocalcemia. This paper describes such a case resulting from maternal vitamin D deficiency.

Case report: A full-term boy, born in December after a normal pregnancy, was admitted at the age of 6 weeks because of dyspnea that appeared during suckling. Examination showed heart failure. Electrocardiogram showed that the corrected QT-interval was lengthened (0.54 s, normal < 0.45 s). Echocardiogram showed dilated, hypokinetic myocardiopathy. His serum calcium concentration was low (1.40 mmol/l) and phosphate was high (2.8 mmol/l); his alkaline phosphatase was 513 Ul/l. His blood PTH concentration was high (120 pg/ml) and his 25 (OH) D was low (5 ng/ml). The patient was given calcium (1 g/m2/day) and 1.25 (OH)2 D (2 micrograms/day orally). His serum calcium returned to normal within 4 days, and his cardiac abnormality was resolved within 3 months. His mother's blood 25 (OH) D concentration was very low (3 ng/ml), 6 weeks after birth.

Conclusion: Neonatal hypocalcemia appears to have been compounded in this case by a maternal vitamin D deficiency. Hence, all pregnant women at risk of deficiency should be given vitamin D.

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[新生儿心力衰竭继发于母亲维生素D缺乏引起的低钙血症]。
背景:心力衰竭是新生儿低钙血症的一种罕见表现。本文描述了一例由母体维生素D缺乏引起的病例。病例报告:一名正常妊娠后12月出生的足月男婴,在6周时因哺乳时出现呼吸困难而入院。检查显示心力衰竭。心电图示校正后qt间期延长(0.54 s,正常< 0.45 s),超声心动图示扩张性心肌病。血钙低(1.40 mmol/l),磷酸高(2.8 mmol/l);碱性磷酸酶为513 Ul/l。血PTH高(120 pg/ml), 25 (OH) D低(5 ng/ml)。患者给予钙(1 g/m2/天)和1.25 (OH) 2d(2微克/天口服)。4天内血钙恢复正常,3个月内心脏异常消失。母亲出生后6周血液中25 (OH) D浓度极低(3 ng/ml)。结论:新生儿低钙血症似乎已经复合在这个情况下,母亲维生素D缺乏。因此,所有有维生素D缺乏风险的孕妇都应该服用维生素D。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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